Published September 05, 2022
Authors: Ebtessam Hamed Nada, Amani Mohamed El-Gharib, and Mahmoud Mandoer
There is clinical evidence that the SARS-CoV-19 has potential neuropathic properties. Several neurologic-related symptoms have been reported including headaches, dizziness, seizure, decreased level of consciousness, acute hemorrhagic necrotizing encephalopathy, agitation, and confusion.
Similarly, hearing loss has been reported in symptomatic and asymptomatic COVID-19 patients who were presented with SNHL whereas other cases had conductive hearing loss. Other symptoms reported with COVID were tinnitus and dizziness despite being less frequent. On the other hand, in the same study by Soylemez, E., and Ertuguul, S. they stated that the vestibular compensation mechanism may hide vestibular symptoms and subsequently they recommended vestibular evaluation to be done with objective tests in these patients.
Now, it is strongly believed that any unexplained symptom affecting any body system may be attributed to COVID-19. We in our practice have noticed a significant increase in the rate of some audio-vestibular complaints in comparison to those before the pandemic, so we aimed at the descriptive analysis of the common audio-vestibular complaints encountered among patients with CVOID.
One hundred twenty-eight patients diagnosed as COVID-19 with audio-vestibular complaints were subjected to audio-vestibular assessment and were included in the study.
In our study on COVID-19 patients who reported audio-vestibular complaints, hearing loss was found in 43.8% of patients in comparison to vertigo that represented 40.6% of cases. The most common type was sensorineural hearing loss representing 29.7% of patients and which was unilateral and sudden in 35.7% of them. Less commonly conductive hearing loss (CHL) was found in 14.1% of cases the most common form was bilateral mild to moderate CHL (83.3%) due to bilateral middle ear effusion.
Among cases with vertigo, the most common etiology was benign paroxysmal positional vertigo (BPPV) (42.5%) then uncompensated vestibular neuritis (VN) (31.5%), and lastly, combined BPPV with VN (25%) of cases. Less frequently we found tinnitus in (13.3%) which was bilateral in (64.7%), labyrinthitis (5.5%), and acute VN 5.5%).
The significant increase in the number of audiovestibular complaining cases that were observed in the course of the recurrent waves’ peaks pushed us to study the relationship between the pandemic and the audiovestibular system. The effect of COVID on AV systems is well noticed and management would be mandatory.